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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes TLC And ESR Levels To Be High Even After Medication?

Hi, my mother is 62 years old and she had a diagnosis of Pyelonephritis 2 weeks back and was treated with anti biotics (Cipro) and other drugs in the hospital and discharged after fever went down. She is still on 2 different anti-biotics that were given based on her urine culture report. She is on daily diabetes medication and takes cortico-steroids for previous health issues. As per lab test yesterday, her TLC is still high (~17000) and ESR is 70. Is there a possibility of she having fungal infection. Can you please suggest any other tests or treatment to for this condition?Thank You!
Tue, 18 Mar 2014
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Diabetologist 's  Response
Hi, welcome to our site. I am Dr Saumya Mittal.

Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query

there are many aspects to this question, some of which are not mentioned in the information provided in the query. I will try to answer them.

First, the ESR may be high due to the "previous health issues". Now you have not mentioned exactly what they were so I am not sure how to answer you about ESR. But considering you are getting steroids dueto these conditons, i would attribute the raised ESR to it

Now you need to understand that the sugars are going to be much higher if the steroids are still on. The fact remains that the high and uncontrolled sugars make the infection healing difficult and it takes longer to treat the infection. So the TLC may be still high. Again from the query, I cannot assess the ongoing sugar levels.

There of course is a possibility of fungal infection. this is specially so in the case of a diabetic. so i would suggest you get a culture repeated. This will not only tell us how much the infection is cured, but a specific mention of fungal culture will help the lab to look for fungus

A repeat urine routine is also suggested, as urine culture takes a longer time. If she is still developing fever, I would suggest a blood culture as well in a patient I was treating

I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck.

I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.

Please do understand that some details could be extracted from a detailed history and examination.

Looking forward to your return query with the details asked so that I can help you further. Please feel free to ask another query. Would be glad to help you.
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What Causes TLC And ESR Levels To Be High Even After Medication?

Hi, welcome to our site. I am Dr Saumya Mittal. Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query there are many aspects to this question, some of which are not mentioned in the information provided in the query. I will try to answer them. First, the ESR may be high due to the previous health issues . Now you have not mentioned exactly what they were so I am not sure how to answer you about ESR. But considering you are getting steroids dueto these conditons, i would attribute the raised ESR to it Now you need to understand that the sugars are going to be much higher if the steroids are still on. The fact remains that the high and uncontrolled sugars make the infection healing difficult and it takes longer to treat the infection. So the TLC may be still high. Again from the query, I cannot assess the ongoing sugar levels. There of course is a possibility of fungal infection. this is specially so in the case of a diabetic. so i would suggest you get a culture repeated. This will not only tell us how much the infection is cured, but a specific mention of fungal culture will help the lab to look for fungus A repeat urine routine is also suggested, as urine culture takes a longer time. If she is still developing fever, I would suggest a blood culture as well in a patient I was treating I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with the details asked so that I can help you further. Please feel free to ask another query. Would be glad to help you. (If the answer has helped you, please indicate this)